Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve EmanueleMilan, Italy.
Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, BIOMETRA, Humanitas Clinical and Research Hospital, University of Milan, Via Manzoni, 56, 20072, Milan, Italy.
Aesthetic Plast Surg. 2024 Aug;48(15):2812-2817. doi: 10.1007/s00266-024-03907-4. Epub 2024 Mar 14.
Rhinoplasty, a common surgical procedure for nose reshaping, demands meticulous preoperative evaluation and precise execution. When coupled with septoplasty to address medical issues stemming from a deviated nasal septum, these procedures can lead to noteworthy postoperative complications. These encompass early issues like epistaxis and hematoma, as well as long-term challenges such as scarring and aesthetic deformities. Strategies like steroids and tranexamic acid are employed to prevent and manage these complications. A contentious aspect in postoperative care is the use of nasal packing. While some argue it aids healing and hemostasis, others avoid it due to patient discomfort. This review assesses the pros and cons of postoperative nasal packing following rhinoplasty and septoplasty. A thorough literature review spanning 2000-2023 yielded 30 relevant articles from 62. Discussion reveals that nasal packing offers limited benefits in reducing bleeding, edema and ecchymosis. In conclusion, the decision to employ nasal packing in rhinoplasty and septoplasty should be made carefully, considering patient comfort and surgical context. Evidence suggests that nasal packing may not consistently provide significant advantages and could lead to adverse outcomes. Nasal splints offer similar advantages and may be considered viable alternatives. Surgeons should tailor their approach to individual patient needs, with further research needed to refine postoperative management for these procedures.Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
隆鼻术是一种常见的鼻部整形手术,需要进行细致的术前评估和精确的操作。当与鼻中隔成形术结合以解决因鼻中隔偏曲引起的医学问题时,这些手术可能会导致显著的术后并发症。这些并发症包括早期的鼻出血和血肿,以及长期的瘢痕和美学畸形等挑战。可以使用类固醇和氨甲环酸等策略来预防和处理这些并发症。术后护理中一个有争议的方面是使用鼻腔填塞物。虽然有些人认为它有助于愈合和止血,但也有人因为患者的不适而避免使用它。这篇综述评估了隆鼻术和鼻中隔成形术后使用鼻腔填塞物的优缺点。通过对 2000 年至 2023 年的文献进行全面综述,从 62 篇文章中获得了 30 篇相关文章。讨论表明,鼻腔填塞物在减少出血、肿胀和瘀斑方面的益处有限。总之,在隆鼻术和鼻中隔成形术中是否使用鼻腔填塞物的决定应根据患者的舒适度和手术情况谨慎做出。有证据表明,鼻腔填塞物并不总是提供显著的优势,反而可能导致不良后果。鼻腔夹板提供了类似的优势,可能是可行的替代方案。外科医生应根据患者的个体需求调整治疗方法,需要进一步研究来完善这些手术的术后管理。证据等级 III 本期刊要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266 。